ECDC chief airs lessons learned during E coli outbreak

Jul 6, 2011 (CIDRAP News)  Europe's Escherichia coli O104:H4 outbreak is a reminder that even countries with strong public health systems are vulnerable to epidemics and that systems for detecting and responding to diseases need to be continually strengthened, Dr Marc Sprenger, director of the European Centre for Disease Prevention and Control (ECDC) said yesterday.

Sprenger spoke about lessons learned during the E coli outbreaks linked to Egyptian fenugreek sprouts in Germany and France yesterday at a meeting in Sopot, Poland, of European Union (EU) health ministers, according to an ECDC press release.

In an outbreak update, the ECDC said today that it has received reports of 25 more E coli O104:H4 infections, including 1 with hemolytic uremic syndrome (HUS), all from Germany. The total now stands at 4,236 infections in Europe, including 898 cases of HUS and 50 deaths.

The ECDC said it doesn't have any new totals on the French outbreak, which for now includes eight confirmed cases, including six with HUS. Eight more infections are suspected, including one patient with HUS.

Sprenger said the outbreak "has happened in the heart of Europe, in rich countries with well resourced public health systems," according to a text of his speech posted on the ECDC Web site.

"Even worse, people hit by this outbreak were mostly women and men in their prime, who thought they were eating healthy food," he said. "Hundreds of them have been damaged for the rest of their lives, suffering kidney failure, brain damage and other long term disabilities."

He said EU-wide networks played a vital role in responding to the outbreak. For example, he said lab experts helped quickly analyze the rare E coli O104:H4 strain. He added that early guidance from the ECDC on lab tests to confirm infections helped officials get a more accurate picture of the developing outbreak.

The European Commission took the lead in coordinating the EU-wide investigation, with the ECDC and the European Food Safety Authority (EFSA) supporting the activities, Sprenger said, adding, "My clear impression is that our actions had an added value."

However, he said the outbreak showed that more efforts are needed to strengthen epidemic response. Though it was useful having an ECDC liaison officer imbedded in the German outbreak investigation team, the ECDC is working on a description of the officer's role, which will include input from EU nations.

"If we can do this ahead of the next outbreak, then we can deploy a liaison officer even more quickly and efficiently," Sprenger said.

Another lesson is that temporary networks are needed to exchange clinical information during outbreaks, he said.

Close cooperation of all sectors is essential for risk assessment, Sprenger said, because speaking to citizens and policymakers with one voice is key.

The E coli outbreak shows that what might look like a local outbreak can quickly affect the rest of the EU, he added.